Topical immune response modifiers: Adjuvants

Annemarie Uliasz, Mark G. Lebwohl

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

Imiquimod and ingenol mebutate are topical treatments widely utilized for their anti-tumor effects on actinic keratosis (AK). In addition to their anti-tumor effects, both topical medications are reported to be effective as off-label alternatives to treat various viral, inflammatory, and malignant skin conditions. Imiquimod is a topical immune modulator approved for the treatment of actinic keratoses, anogenital warts, and superficial basal cell carcinomas. Imiquimod exhibits anti-viral and anti-tumor effects by stimulating both the innate and adaptive immune responses via toll-like receptors (TLR). TLRs on antigen presenting cells induce the production of T-helper-1 cytokines leading to malignant cell death. The dosage, application, and duration depend on the condition being treated. The medication is largely well-tolerated, with application site reactions expected. Ingenol mebutate is derived from the sap of the Euphorbia peplus plant. It has a dual mechanism of action comprised of initial rapid cell death followed by an acute inflammatory response. It is available as a topical gel and is administered over 2-3 days and has a favorable safety profile, making it an appealing alternative to other spot and field therapies.

Original languageEnglish
Title of host publicationClinical and Basic Immunodermatology
Subtitle of host publicationSecond Edition
PublisherSpringer International Publishing
Pages775-790
Number of pages16
ISBN (Electronic)9783319297859
ISBN (Print)9783319297835
DOIs
StatePublished - 24 Apr 2017

Keywords

  • Actinic keratosis
  • Imiquimod
  • Ingenol mebutate
  • Protein kinase C Field therapy
  • Toll-like receptors

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